Pneumothorax complicating small-bore feeding tube placement.

Small-bore Silastic feeding tubes are being used with increasing frequency for short- and long-term enteral hyperalimentation. We present three cases where these flexible tubes were passed into the tracheobronchial tree and then out into the pleural space. The result in each case was a pneumothorax or hydropneumothorax.

Reactive airway dysfunction syndrome in three police officers following a roadside chemical spill.

The reactive airway dysfunction syndrome (RADS) is a recently described syndrome in which bronchial hyperreactivity and asthmatic symptoms develop in previously healthy individuals after a single large exposure to an irritating gas, fume, or vapor. We report a cluster of three Philadelphia police officers who developed RADS after a common exposure to toxic fumes from a roadside truck accident. Results of initial pulmonary function testing were normal in all three, and methacholine challenge was required for diagnosis in two out of the three.

Angiosarcoma presenting as diffuse alveolar hemorrhage.

Angiosarcoma has been reported as occurring in both postirradiation and postradical mastectomy patients. Described is a patient, postmastectomy and irradiation, with alveolar hemorrhage secondary to angiosarcoma. Angiosarcoma, primary or metastatic to lung, should be included in the differential diagnosis of diffuse alveolar hemorrhage in this patient population.

Sarcoma of the pulmonary artery.

A patient is described in whom clinical presentation, V/Q scan, and pulmonary angiogram were consistent with pulmonary embolus. No improvement occurred despite therapy with heparin. When sent for surgical embolectomy, sarcoma of the pulmonary artery was diagnosed.